Insurance Benefits

The benefit coordinators here at Healthy Smiles of Pearland explain, summarize, and publish material which describes to the patient their rights and obligations under their own individual policy.

Here at Healthy Smiles of Pearland the benefit coordinator plays a big role in making sure the patient is eligible and up to date with their insurance. There is information regarding insurance that the patient might not be familiar with regarding potential treatment, waiting periods or missing tooth clause ect . Dr. Casquete and the team are here to assist our patient’ s needs to better serve their hygiene, health, and appearance.

You may have annual benefits that you must claim by the end of the year or lose them. Contact our friendly Benefit coordinator to help you get all the value you’ ve paid for!

WHAT YOU SHOUD KNOW ABOUT DENTAL INSURANCE CLAUSES:

Missing tooth clause
On most insurance there is a missing tooth clause and many people are not a where nor do they know what a missing clause is. A missing tooth clause protects the insurance company from paying for the replacement of a tooth that was missing before the policy was in effect.

For example if you lost a tooth prior to your insurance and you later decide you would like to have an implant, partial, or bridge in place of the missing tooth or teeth, the insurance wouldn’ t have to pay for that service due to the missing tooth clause.

Waiting Periods
Many insurance companies have waiting periods on new policies. A waiting period is a length of time that an insurance company will make you wait until you are covered before they will pay on a variety of procedures.

For example if you are needing a crown or root canal you may have to wait up to 12 months before they will cover a percentage on that service.

Replacement Clause
Almost all insurance companies have a replacement cause in the policy. A replacement clause will not pay to replace a produce such as bridges, dentures, and other treatment until the guideline time has been passed.

Morgan Hunter
12004 Shadow Creek Pkwy
Pearland, Tx. 77584
Office (713)340-1192
www.pearlanddentalspa.com